Injecting insulin
thumb|300px|left|Dolly the Yorkie getting one of her two insulin shots a day. Injecting insulin at home is done subcutaneously, under the skin, but not into muscle or vein. See also Syringe and Insulin pen. How to inject subcutaneously thumb|300px|left|How to Give a Dog a Shot It's best to pull up some loose skin into a tent then insert the needle firmly, bevel side upSarasota Memorial Hospital Subcutaneous Injection Page 4 for comfort. BD has animations with narrations to help you learn how to draw insulin properlyBD Diabetes-Drawing Insulin Animation with Narration. One can select from drawing one insulin or combining two insulins in the same syringe. Selecting this and the style of syringe you use personalizes the demo for your needs. The presentation is very clear and unhurried. BD also has a slideshow which shows how to inject your dogBD Diabetes Slideshow-Injecting a Dog. Injection tips * Do NOT wipe the needle with alcohol as it removes the protective coating. The coating makes injection easier and less painfulPetDiabetes.org-Tips for Comfortable Injections. * Injecting any insulin at the same site repeatedly over time or blunting a needle with re-useInsulin-Dependent Diabetes-Dr. Ragnar Hanas-Page 21 can cause a lipodystrophy: either lipoatrophyLipoatrophy can Happen With Any Subcutaneous Insulin-Endocrine Abstracts-2006 or lipohypertrophy. Either makes absorption unreliable. But varying the injection site can cause variability in action profile, too. This page illustratesCommon Human Insulin Injection Areas & Their Absorption Rates illustrates the most common areas humans with diabetes inject insulin and explains how absorption differs in various areas of the human body. This is true for ALL insulins. The new shot area needn't be very far from where the last shot was given--the distance of the width of 2 fingers will do fine as a measureJoslyn Diabetes Center-Tips for Injecting Insulin. Most of us dealing with pet diabetes vary the side we give the injections in--right side mornings and left side evenings, for example. This is another help in avoiding giving shots in the same areasBD Diabetes-FAQ's About Diabetic Dogs-Dr. Greco. * Many people give insulin shots in the scruff of the pet's neck, which is now considered to be a less than optimum choice. The neck area provides poor insulin Absorption, due to it not having many capillaries, veins. etc. (vascularization). Other sites suggested by Dr. Greco include the flank and armpitBetter Medicine E-Newsletter-June 2006. Intervet recommends giving injections from just back of the shoulder blades to just in front of the hipbone on either side, from 1 to 2 inches from the middle of the backVetsulin-Preparing Insulin & Giving Injection-Page 2. *'To eliminate bubbles': If drawing insulin from a vial, set the syringe plunger to the dosage you want to draw, put the needle into the top of the vial while the vial is still upright, and push all the air out of the syringe. This will maintain air pressure equilibrium in the vial once you draw the dose and, because the vial is upright, will not cause air bubbles to mix with the solution. Turn the vial upside down and draw the insulin slowly. :*If you do get air bubbles into the syringe, it's ok with most insulins to re-inject the insulin into the vial and draw again until the air is goneInjecting Insulin-Transcript of American Diabetes Association Videotape-2003. Check that this is ok with your insulin. See also injecting insulin. Slower draw is less likely to draw bubbles. :*Another way to get rid of syringe air bubbles is to hold the syringe upright and give it a tap or two with your fingerHow to Get Bubbles Out of Vetsulin (or any insulin)-eHow. The problem with having air bubbles in the injection is that you will not be getting the full dose of insulin; the bubbles take the place of it American Diabetes Association 2002 Position Statement-Insulin Administration. :*Some people prefer to gently jiggle their vials to make any air bubbles rise to the top, away from where the needle will draw. *If you should bend a needle while drawing insulin, discard the syringe and start again; don't try to straighten it outInjecting Insulin-Transcript of American Diabetes Association Videotape. Inserting the needle all the way into the vial makes it less easy to bendWashington State University-Diabetes Mellitus. Insulin tips Cold insulin Cold insulinInjecting Cold Insulin-Diabetes Journals can sting, regardless of what species, type or brand. Bringing the insulin to room temperature by removing it from the fridge before actually using it can help avoid painful injections. Warming the capped insulin syringe with your hands can have the same effectPetTalk.com-Tips and Tricks from Pet Owners. Some people tuck the capped and filled syringe under their arm for a few minutes to warm it before use. Do NOT attempt to warm insulin using a stove, microwave, etc.; you may destroy the insulin by doing soPet Diabetes Injection Tips. Don't Rub Injection Site! Rubbing the site where you gave the shot increases insulin absorptionInsulin Treatment-Factors Affecting Insulin Action. This means that the insulin is used faster than normal (no rubbing of the site) and might lead to a hypo. Rubbing the site increases blood flow to the area and this in turn speeds up absorptionInsulin in the Hospital Setting, Ira B. Hirsch, U of Washington Medical Center-Page 8Insulin Dependent Diabetes in Children, Adolescents and Adults-Dr. Ragnar Hanas-Page 11-Factors Influencing the Insulin Effect. Vary Injection Site Placement of Insulin Injections can make a big difference. Absorption problems can occur possibly causing hypoglycemiaInsulin-Section 6.1-Kinetics-InChem or hyperglycemia if the insulin injection sites are not varied.Cook-Identifying the reasons behind difficult-to-control diabetes in dogs-1 April 2010-DVM 360 The area needn't be very far from where the last shot was given--the distance of the width of 2 fingers will do fine as a measureJoslyn Diabetes Center-Tips for Injecting Insulin. When shots are given again & again into an area of skin, the tissue becomes thicker at that point; a fairly good analogy would be the calluses people get on hands and feet. The callus skin is thicker and harder; injection areas become similar to this too from repeated shots. This thicker, harder skin doesn't let the body absorb the injected insulin as well as thinner, non-hardened areasBD Diabetes-Injection Site Selection. Most of us dealing with pet diabetes vary the side we give the injections in--right side mornings and left side evenings, for example. This is another help in avoiding giving shots in the same areas. Many people give insulin shots in the scruff of the pet's neck, which is now considered to be a less than optimum choice. The neck area provides poor insulin absorption, due to it not having many capillaries, veins. etc. (vascularization). :Other sites suggested by Dr. Greco include the flank and armpitBetter Medicine E-Newsletter-June 2006. :Intervet recommends giving injections from just back of the shoulder blades to just in front of the hipbone on either side, from 1 to 2 inches from the middle of the backVetsulin-Preparing Insulin & Giving Injection-Page 2. Do not use the insulin if Before each use, take a moment to inspect the insulin prior to drawing it into the syringe; clear insulins should appear not discolored and clear; suspended insulins should be uniform in their cloudinessRxEd.org-Insulin Therapy-Stability & Storage. Injection problems There are sometimes leakage problems, when some insulin is lost when the needle is removed from the skinInsulin Leaking From Injection Site-Ask the D Team. Some possible reasons and "fixes" for this are holding the "pinch" or "squeeze" too long which you made to give the shot. The skin, now with insulin under it, is still being "squeezed" as it was before the insulin went under the skin. The "pinch" forces some of the insulin back out from the newly-created hole in the skin. Releasing the "squeeze" or "pinch" first, then counting to 10 before removing the needle from the skin may give the insulin time to penetrate the fat layer and prevent leakage. Short needles can also cause insulin leakage--switching to longer ones can also help. See also diluting insulin, combining insulin, rolling insulin, syringes, Insulin use tips and Insulin pens. References More Information *Washington State University-Diabetes Mellitus Good general information with photos and tips about drawing insulin. *PetTalk.com-Tips and Tricks from Pet Owners-Alternative to Tent Method Technique Drawing Insulin Pictorial *BD Animations-Drawing Insulin Dogs - Pictorials *BD Pictorial for dogs Insulin Injections Slideshow *Another one for Dogs-Intervet *BD Diabetes--Selecting Injection Sites Dogs - Online Videos *Dogs Part 1-Intervet *Dogs Part 2-Intervet *Cornell University Feline Health Center-Giving Insulin Injections Flash Movie This contains good general information about drawing insulin and how to give insulin injections--not strictly for cats. Dogs - Injection Time Tips *Tips on Giving Dogs Shots--Making it less Stressful-HealthyPet.com Injection Site Rotation *Rotating sites-BD Diabetes *Diabetic Skin Disorders Category:Insulins Category:Tips Category:Treatments Category:Introduction Category:Content